JEFFREY THOMAS MANTERNACH OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935084

License Status

CANCELLED

Business

First Name

JEFFREY

Middle

THOMAS

Last Name

MANTERNACH

Suffix

Business Name

JEFFREY THOMAS MANTERNACH OD

Original Issue Date

02/16/2009

Effective Date

02/16/2009

Expiration Date

03/31/2010

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

05/04/2010